Digital Commons Network^™

Effect Of Hyperchloremia On Acute Kidney Injury In Critically Ill Septic Patients: A Retrospective Cohort Study, Lenar Yessayan, Javier A. Neyra, Fabrizio Canepa-Escaro, George Vasquez-Rios, Michael Heung, Jerry Yee, Jerry Yee

Nephrology Articles

BACKGROUND: Hyperchloremia is common in critically ill septic patients. The impact of hyperchloremia on the incidence of acute kidney injury (AKI) is not well studied. We investigated the association between hyperchloremia and AKI within the first 72 h of intensive care unit (ICU) admission.

METHODS: 6490 ICU adult patients admitted with severe sepsis or septic shock were screened for eligibility. Exclusion criteria included: AKI on admission, baseline estimated glomerular filtration rate (eGFR)/min/1.73 m

RESULTS: A total of 1045 patients were available for analysis following the implementation of eligibility criteria: 303 (29%) had hyperchloremia (Cl

CONCLUSIONS: Hyperchloremia occurs commonly among critically …

Association Between Cognitive Function And Quality Of Life In Patients With Head And Neck Cancer, Amy M. Williams, Jamie Lindholm, Diana Cook, Farzan Siddiqui, Tamer Ghanem, Steven S. Chang

Otolaryngology Articles

No abstract provided.

Kdoqi Us Commentary On The 2017 Kdigo Clinical Practice Guideline Update For The Diagnosis, Evaluation, Prevention, And Treatment Of Chronic Kidney Disease-Mineral And Bone Disorder (Ckd-Mbd), Tamara Isakova, Thomas L. Nickolas, Michelle Denburg, Sri Yarlagadda, Daniel E. Weiner, Orlando M. Gutiérrez, Vinod Bansal, Sylvia E. Rosas, Sagar Nigwekar, Jerry Yee, Holly Kramer

Nephrology Articles

Chronic kidney disease-mineral and bone disorder (CKD-MBD) encompasses laboratory and bone abnormalities and vascular calcification and has deleterious effects on clinical outcomes. KDOQI (Kidney Disease Outcomes Quality Initiative), an initiative of the National Kidney Foundation, addressed this issue with the publication of a clinical practice guideline for bone metabolism and disease in CKD in 2003, and 2 years later, a new definition and classification scheme for CKD-MBD was developed following a KDIGO (Kidney Disease: Improving Global Outcomes) Controversies Conference. The initial KDIGO guideline on CKD-MBD was then published in 2009. New evidence was subsequently reviewed at the 2013 KDIGO Controversies …

Laser-Induced Neocollagenesis In Focal Dermal Hypoplasia Associated With Goltz Syndrome In A Girl, Andrew C. Krakowski, David M. Ozog, David Ginsberg, Carol Cheng, Marsha Chaffins

Pathology and Laboratory Medicine Articles

Importance: Current models of Goltz syndrome cannot estimate the overall neocollagenesis and marked shift in collagen types after ablative fractional laser resurfacing (AFR) within treated areas of focal dermal hypoplasia (FDH).

Objectives: To clinically improve FDH by using AFR to characterize the specific ratio of collagen types associated with observed clinical changes.

Design, Setting, and Participants: This case report of a girl with Goltz syndrome used extensive laboratory evaluation and multiple observers blinded to the patient's clinical status. Serial samples of clinically unaffected skin constituted internal control specimens, with clinical and histologic evaluations performed as part of a multicenter investigation. …

Combination Of Carmustine And Selenite Inhibits Egfr Mediated Growth Signaling In Androgen-Independent Prostate Cancer Cells., Vijayalakshmi Thamilselvan, Mani Menon, Gary S. Stein, Frederick A. Valeriote, Sivagnanam Thamilselvan

Urology Articles

Although aberrant androgen receptor (AR) signaling is a central mechanism for castration resistant prostate cancer (CRPC) progression, AR-independent growth signaling is also present in CRPC. The current therapeutic options for patients with CRPC are limited and new drugs are desperately needed to eliminate these crucial growth signaling pathways. We have previously shown that combination of carmustine and selenite effectively induces apoptosis and growth inhibition by targeting AR and AR-variants in CRPC cells. High levels of EGFR expression present in the CRPC cells mediates the cell proliferation via AR-independent growth signaling mechanisms. Therefore, in this study, we investigated whether the combination …

Comparison Of Inappropriate Shocks And Other Health Outcomes Between Single- And Dual-Chamber Implantable Cardioverter-Defibrillators For Primary Prevention Of Sudden Cardiac Death: Results From The Cardiovascular Research Network Longitudinal Study Of Implantable Cardioverter-Defibrillators, Pamela N. Peterson, Robert T. Greenlee, Alan S. Go, David J. Magid, Andrea E. Cassidy-Bushrow, Romel Garcia-Montilla, Karen A. Glenn, Jerry H. Gurwitz, Stephen C. Hammill, John Hayes, Alan Kadish, Kristi Reynolds, Param Sharma, David H. Smith, Paul D. Varosy, Humberto Vidaillet, Chan X. Zeng, Sharon-Lise T. Normand, Frederick A. Masoudi

Public Health Sciences Articles

BACKGROUND: In US clinical practice, many patients who undergo placement of an implantable cardioverter-defibrillator (ICD) for primary prevention of sudden cardiac death receive dual-chamber devices. The superiority of dual-chamber over single-chamber devices in reducing the risk of inappropriate ICD shocks in clinical practice has not been established. The objective of this study was to compare risk of adverse outcomes, including inappropriate shocks, between single- and dual-chamber ICDs for primary prevention.

METHODS AND RESULTS: We identified patients receiving a single- or dual-chamber ICD for primary prevention who did not have an indication for pacing from 15 hospitals within 7 integrated health …

Learning From Kids, Alicia Neu, Jerry Yee

Nephrology Articles

No abstract provided.

A Point System To Forecast Hepatocellular Carcinoma Risk Before And After Treatment Among Persons With Chronic Hepatitis C, Jian Xing, Philip R. Spradling, Anne C. Moorman, Scott D. Holmberg, Eyasu H. Teshale, Loralee B. Rupp, Stuart C. Gordon, Mei Lu, Joseph A. Boscarino, Mark A. Schmidt, Connie M. Trinacty, Fujie Xu

Gastroenterology Articles

BACKGROUND: Risk of hepatocellular carcinoma (HCC) may be difficult to determine in the clinical setting.

AIM: Develop a scoring system to forecast HCC risk among patients with chronic hepatitis C.

METHODS: Using data from the Chronic Hepatitis Cohort Study collected during 2005-2014, we derived HCC risk scores for males and females using an extended Cox model with aspartate aminotransferase-to-platelet ratio index (APRI) as a time-dependent variables and mean Kaplan-Meier survival functions from patient data at two study sites, and used data collected at two separate sites for external validation. For model calibration, we used the Greenwood-Nam-D'Agostino goodness-of-fit statistic to examine …

Role Of Kindness In Cancer Care, Leonard L. Berry, Tracey S. Danaher, Robert A. Chapman, Rana Awdish

Hematology/Oncology Articles

The wonders of high-tech cancer care are best complemented by the humanity of high-touch care. Simple kindnesses can help to diffuse negative emotions that are associated with cancer diagnosis and treatment-and may even help to improve patients' outcomes. On the basis of our experience in cancer care and research, we propose six types of kindness in cancer care: deep listening , whereby clinicians take the time to truly understand the needs and concerns of patients and their families; empathy for the patient with cancer, expressed by both individual clinicians and the care culture, that seeks to prevent avoidable suffering; generous …

Clinical Assessment Of Cognitive Function In Patients With Head And Neck Cancer: Prevalence And Correlates, Amy M. Williams, Jamie Lindholm, Farzan Siddiqui, Tamer Ghanem, Steven S. Chang

Otolaryngology Articles

Objective: Identify the prevalence and clinical correlates of cognitive impairment in patients presenting for treatment of head and neck cancer (HNC) using brief screening within a multidisciplinary care team.

Study Design: A case series with planned data collection of cognitive function, quality of life (QoL), and psychosocial variables.

Setting: Urban Midwest academic medical center.

Subjects and Methods: In total, 209 consecutive patients with a diagnosis of HNC between August 2015 and September 2016 who had a pretreatment assessment with a clinical health psychologist. At pretreatment assessment, the Montreal Cognitive Assessment (MoCA), a brief screening tool for cognitive function, was administered …

Radiological Diagnosis Of Drop Metastases From Paediatric Brain Tumours Using Combination Of 2d And 3d Mri Sequences, S F. Kralik, D P. O'Neill, A P. Kamer, E Rodriguez, C Y. Ho

Diagnostic Radiology Articles

AIM: To evaluate spinal magnetic resonance imaging (MRI) examinations using a combination of two-dimensional (2D) and three-dimensional (3D) MRI sequences for diagnosis of drop metastases.

MATERIALS AND METHODS: Fifty-five paediatric patients with primary brain tumours were evaluated for drop metastases at initial presentation using spinal MRI including sagittal 2D T1-weighted (W) contrast-enhanced (+C), axial 3D T1W+C volumetric interpolated breath-hold (VIBE), and sagittal 3D T2W SPACE (Sampling Perfection with Application optimised Contrasts using different flip angle Evolutions).

RESULTS: The MRI false-negative rate was 4%, and cerebrospinal fluid (CSF) false-negative rate was 16% (p=0.07). The 3D T1W+C VIBE increased the number of …

Direct Oral Anticoagulant- Vs Vitamin K Antagonist-Related Nontraumatic Intracerebral Hemorrhage, Georgios Tsivgoulis, Vasileios-Arsenios Lioutas, Panayiotis N. Varelas, Aristeidis H. Katsanos, Nitin Goyal, Robert Mikulik, Kristian Barlinn, Christos Krogias, Vijay K. Sharma, Konstantinos Vadikolias, Efthymios Dardiotis, Theodore Karapanayiotides, Alexandra Pappa, Christina Zompola, Sokratis Triantafyllou, Odysseas Kargiotis, Michael Ioakeimidis, Sotirios Giannopoulos, Ali Kerro, Argyrios Tsantes, Chandan Mehta, Mathew Jones, Christoph Schroeder, Casey Norton, Anastasios Bonakis, Jason Chang, Anne W. Alexandrov, Panayiotis Mitsias, Andrei V. Alexandrov

Neurology Articles

OBJECTIVE: To compare the neuroimaging profile and clinical outcomes among patients with intracerebral hemorrhage (ICH) related to use of vitamin K antagonists (VKAs) or direct oral anticoagulants (DOACs) for nonvalvular atrial fibrillation (NVAF).

METHODS: We evaluated consecutive patients with NVAF with nontraumatic, anticoagulant-related ICH admitted at 13 tertiary stroke care centers over a 12-month period. We also performed a systematic review and meta-analysis of eligible observational studies reporting baseline characteristics and outcomes among patients with VKA- or DOAC-related ICH.

RESULTS: We prospectively evaluated 161 patients with anticoagulation-related ICH (mean age 75.6 ± 9.8 years, 57.8% men, median admission NIH Stroke …

Diagnosing Primary Squamous Cell Cancer Of The Rectum In A Patient With Hiv: A Case Report, Pushpinderdeep Kahlon, Ashish Mishra, Todd R. Williams, Nimrat K. Sandhu, Vijayalakshmi Donthireddy, Irina Dobrostoskaya

Diagnostic Radiology Articles

No abstract provided.

Pooled Analysis Of Individual Patient Data On Concurrent Chemoradiotherapy For Stage Iii Non-Small-Cell Lung Cancer In Elderly Patients Compared With Younger Patients Who Participated In Us National Cancer Institute Cooperative Group Studies, Thomas E. Stinchcombe, Ying Zhang, Everett E. Vokes, Joan H. Schiller, Jeffrey D. Bradley, Karen Kelly, Walter J. Curran, Steven E. Schild, Benjamin Movsas, Gerald Clamon, Ramaswamy Govindan, George R. Blumenschein, Mark A. Socinski, Neal E. Ready, Wallace L. Akerley, Harvey J. Cohen, Herbert H. Pang, Xiaofei Wang

Radiation Oncology Articles

Purpose Concurrent chemoradiotherapy is standard treatment for patients with stage III non-small-cell lung cancer. Elderly patients may experience increased rates of adverse events (AEs) or less benefit from concurrent chemoradiotherapy. Patients and Methods Individual patient data were collected from 16 phase II or III trials conducted by US National Cancer Institute-supported cooperative groups of concurrent chemoradiotherapy alone or with consolidation or induction chemotherapy for stage III non-small-cell lung cancer from 1990 to 2012. Overall survival (OS), progression-free survival, and AEs were compared between patients age ≥ 70 (elderly) and those younger than 70 years (younger). Unadjusted and adjusted hazard ratios …

Effects Of Intensive Bp Control In Ckd, Alfred K. Cheung, Mahboob Rahman, David M. Reboussin, Timothy E. Craven, Tom Greene, Paul L. Kimmel, William C. Cushman, Amret T. Hawfield, Karen C. Johnson, Cora E. Lewis, Suzanne Oparil, Michael V. Rocco, Kaycee M. Sink, Paul K. Whelton, Jackson T. Wright, Jan Basile, Srinivasan Beddhu, Udayan Bhatt, Tara I. Chang, Glenn M. Chertow, Michel Chonchol, Barry I. Freedman, William Haley, Joachim H. Ix, Lois A. Katz, Anthony A. Killeen, Vasilios Papademetriou, Ana C. Ricardo, Karen Servilla, Barry Wall, Dawn Wolfgram, Jerry Yee

Nephrology Articles

The appropriate target for BP in patients with CKD and hypertension remains uncertain. We report prespecified subgroup analyses of outcomes in participants with baseline CKD in the Systolic Blood Pressure Intervention Trial. We randomly assigned participants to a systolic BP target of(intensive group;

Sodium Homeostasis In Chronic Kidney Disease, Vivek Soi, Jerry Yee

Nephrology Articles

The pathologic consequences of sodium retention in the CKD population can lead to hypertension, edema, and progressive disease. Sodium excess is responsible for increases in oxidative stress, which alters kidney vasculature. As progression of CKD occurs, hyperfiltration by remaining nephrons compensates for an overall decrease in the filtered load of sodium. In the later stages of CKD, compensatory mechanisms are overcome and volume overload ensues. Nephrotic syndrome as it relates to sodium handling involves a different pathophysiology despite a common phenotype. Extrarenal sodium buffering is also examined as it has significant implications in the setting of advanced CKD.

Hyperkalemia: Inpatient Panik, Jerry Yee

Nephrology Articles

No abstract provided.

Human Milk And Allergic Diseases: An Unsolved Puzzle, Daniel Munblit, Diego G. Peroni, Alba Boix-Amorós, Peter S. Hsu, Belinda Van't Land, Melvin C. L Gay, Anastasia Kolotilina, Chrysanthi Skevaki, Robert J. Boyle, Maria Carmen Collado, Johan Garssen, Donna T. Geddes, Ralph Nanan, Carolyn Slupsky, Ganesa Wegienka, Anita L. Kozyrskyj, John O. Warner

Public Health Sciences Articles

There is conflicting evidence on the protective role of breastfeeding in relation to the development of allergic sensitisation and allergic disease. Studies vary in methodology and definition of outcomes, which lead to considerable heterogeneity. Human milk composition varies both within and between individuals, which may partially explain conflicting data. It is known that human milk composition is very complex and contains variable levels of immune active molecules, oligosaccharides, metabolites, vitamins and other nutrients and microbial content. Existing evidence suggests that modulation of human breast milk composition has potential for preventing allergic diseases in early life. In this review, we discuss …

Determining The Optimal Target Blood Pressure After Thrombectomy: High Or Low?, Katja E. Wartenberg, Stephan A. Mayer

Neurology Articles

No abstract provided.

Recognizing The Continuous Nature Of Expression Heterogeneity And Clinical Outcomes In Clear Cell Renal Cell Carcinoma., Xiaona Wei, Yukti Choudhury, Weng-Khong Lim, John Anema, Richard J. Kahnoski, Brian Lane, John Ludlow, Masayuki Takahashi, Hiro-Omi Kanayama, Arie Belldegrun, Hyung L. Kim, Craig G. Rogers, David Nicol, Bin T. Teh, Min-Han Tan

Urology Articles

Clear cell renal cell carcinoma (ccRCC) has been previously classified into putative discrete prognostic subtypes by gene expression profiling. To investigate the robustness of these proposed subtype classifications, we evaluated 12 public datasets, together with a new dataset of 265 ccRCC gene expression profiles. Consensus clustering showed unstable subtype and principal component analysis (PCA) showed a continuous spectrum both within and between datasets. Considering the lack of discrete delineation and continuous spectrum observed, we developed a continuous quantitative prognosis score (Continuous Linear Enhanced Assessment of RCC, or CLEAR score). Prognostic performance was evaluated in independent cohorts from The Cancer Genome …

In Vivo Study Of Plasmodium Falciparum Chloroquine Susceptibility In Three Departments Of Haiti, Christian P. Raccurt, Philippe Brasseur, Micheline Cicéron, Dana M. Parke, Marcus J. Zervos, Jacques Boncy

Global Health Initiative Articles

BACKGROUND: Malaria is considered a public health priority in Haiti, with a goal to eliminate by year 2020. Chloroquine is the first-line treatment recommended by the Ministry of Public Health and Population. In order to verify the suitability of chloroquine for uncomplicated malaria treatment, an in vivo study of susceptibility of Plasmodium falciparum to chloroquine was conducted from January 2013 to March 2015 in six localities in the south of Haiti.

RESULTS: Sixty-one patients who presented with confirmed P. falciparum malaria were included in the study and followed until day 28 after having taken 25 mg/kg of chloroquine orally over …

Risk Factors For 30-Day Mortality In Patients With Methicillin-Resistant Staphylococcus Aureus Bloodstream Infections, Pedro Ayau, Ana C. Bardossy, Guillermo Sanchez, Ricardo Ortiz, Daniela Moreno, Pamela Hartman, Khulood Rizvi, Tyler Prentiss, Mary Perri, Meredith Mahan, Vanthida Huang, Kate Reyes, Marcus J. Zervos

Infectious Diseases Articles

OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections (BSI) are a major health care problem accounting for a large percentage of nosocomial infections. The aim of this study was to identify risk factors associated with 30-day mortality in patients with MRSA BSI.

METHODS: This was a retrospective study performed in Southeast Michigan. Over a 9- year period, a total of 1,168 patients were identified with MRSA BSI. Patient demographics and clinical data were retrieved and evaluated using electronic medical health records.

RESULTS: 30-day mortality during the 9-year study period was 16%. Significant risk factors for 30-day mortality were age, cancer, …

Free Flap Reconstruction Monitoring Techniques And Frequency In The Era Of Restricted Resident Work Hours, Urjeet A. Patel, David Hernandez, Yelizaveta Shnayder, Mark K. Wax, Matthew M. Hanasono, Joshua D. Hornig, Tamer Ghanem, Matthew Old, Ryan S. Jackson, Levi G. Ledgerwood, Patrik Pipkorn, Lawrence Lin, Adrian Ong, Joshua B. Greene, James Bekeny, Yin Yiu, Salem I. Noureldine, David X. Li, Joel Fontanarosa, Evan Greenbaum, Jeremy D. Richmon

Otolaryngology Articles

Importance: Free flap reconstruction of the head and neck is routinely performed with success rates around 94% to 99% at most institutions. Despite experience and meticulous technique, there is a small but recognized risk of partial or total flap loss in the postoperative setting. Historically, most microvascular surgeons involve resident house staff in flap monitoring protocols, and programs relied heavily on in-house resident physicians to assure timely intervention for compromised flaps. In 2003, the Accreditation Council for Graduate Medical Education mandated the reduction in the hours a resident could work within a given week. At many institutions this new era …

Risk Factors For 30-Day Mortality In Patients With Methicillin-Resistant Staphylococcus Aureus Bloodstream Infections, Pedro Ayau, Ana C. Bardossy, Guillermo Sanchez, Ricardo Ortiz, Daniela Moreno, Pamela Hartman, Khulood Rizvi, Tyler Prentiss, Mary B. Perri, Meredith Mahan, Vanthida Huang, Katherine Reyes, Marcus J. Zervos

Global Health Initiative Articles

OBJECTIVES: Methicillin-resistant Staphylococcus aureus (MRSA) blood stream infections (BSI) are a major health care problem accounting for a large percentage of nosocomial infections. The aim of this study was to identify risk factors associated with 30-day mortality in patients with MRSA BSI.

METHODS: This was a retrospective study performed in Southeast Michigan. Over a 9- year period, a total of 1,168 patients were identified with MRSA BSI. Patient demographics and clinical data were retrieved and evaluated using electronic medical health records.

RESULTS: 30-day mortality during the 9-year study period was 16%. Significant risk factors for 30-day mortality were age, cancer, …

Authentication Of Collagen Vi Antibodies., Jamie Endicott, Paul Holden, Jamie Fitzgerald

Orthopedics Articles

BACKGROUND: Collagen VI is a ubiquitously-expressed macromolecule that forms unique microfibrillar assemblies in the extracellular matrix. Mutations in the COL6A1, COL6A2 and COL6A3 genes result in congenital muscular dystrophy, arguing that collagen is critical for skeletal muscle development and function. Antibodies against collagen VI are important clinical and diagnostic tools in muscular dystrophy. They are used to confirm genetic findings by detecting abnormalities in the distribution, organization and overall levels of collagen VI in cells and tissues isolated from patients.

METHODS: Many antibodies have been raised against tissue-purified collagen VI and individual collagen VI chains, however few have been properly …

Barriers And Facilitators To Reducing Frequent Laboratory Testing For Patients Who Are Stable On Warfarin: A Mixed Methods Study Of De-Implementation In Five Anticoagulation Clinics., Geoffrey D. Barnes, Sevan Misirliyan, Scott Kaatz, Elizabeth A. Jackson, Brian Haymart, Eva Kline-Rogers, Jay Kozlowski, Gregory D. Krol, James B. Froehlich, Anne Sales

Hospital Medicine Articles

BACKGROUND: Patients on chronic warfarin therapy require regular laboratory monitoring to safely manage warfarin. Recent studies have challenged the need for routine monthly blood draws in the most stable warfarin-treated patients, suggesting the safety of less frequent laboratory testing (up to every 12 weeks). De-implementation efforts aim to reduce the use of low-value clinical practices. To explore barriers and facilitators of a de-implementation effort to reduce the use of frequent laboratory tests for patients with stable warfarin management in nurse/pharmacist-run anticoagulation clinics, we performed a mixed-methods study conducted within a state-wide collaborative quality improvement collaborative.

METHODS: Using a mixed-methods approach, …

Local Therapy Improves Survival In Metastatic Prostate Cancer, Sami-Ramzi Leyh-Bannurah, Stéphanie Gazdovich, Lars Budäus, Emanuele Zaffuto, Alberto Briganti, Firas Abdollah, Francesco Montorsi, Jonas Schiffmann, Mani Menon, Shahrokh F. Shariat, Margit Fisch, Felix Chun, Thomas Steuber, Hartwig Huland, Markus Graefen, Pierre I. Karakiewicz

Urology Articles

BACKGROUND: Treatment of the primary, termed local therapy (LT), may improve survival in metastatic prostate cancer (mPCa) versus no local therapy (NLT).

OBJECTIVE: To assess cancer-specific mortality (CSM) after LT versus NLT in mPCa.

DESIGN, SETTING, AND PARTICIPANTS: Within the Surveillance, Epidemiology and End Results database (2004-2013), 13 692 mPCa patients were treated with LT (radical prostatectomy [RP] or radiation therapy [RT]) or NLT.

OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: Multivariable competing risk regression analyses (MVA CRR) tested CSM after propensity score matching (PSM) in two analyses, (1) NLT versus LT and (2) RP versus RT, and were complemented with interaction, …

Avelumab, An Anti-Programmed Death-Ligand 1 Antibody, In Patients With Refractory Metastatic Urothelial Carcinoma: Results From A Multicenter, Phase Ib Study, Andrea B. Apolo, Jeffrey R. Infante, Ani Balmanoukian, Manish R. Patel, Ding Wang, Karen Kelly, Anthony E. Mega, Carolyn D. Britten, Alain Ravaud, Alain C. Mita, Howard Safran, Thomas E. Stinchcombe, Marko Srdanov, Arnold B. Gelb, Michael Schlichting, Kevin Chin, James L. Gulley

Hematology/Oncology Articles

Purpose We assessed the safety and antitumor activity of avelumab, a fully human anti-programmed death-ligand 1 (PD-L1) IgG1 antibody, in patients with refractory metastatic urothelial carcinoma. Methods In this phase Ib, multicenter, expansion cohort, patients with urothelial carcinoma progressing after platinum-based chemotherapy and unselected for PD-L1 expression received avelumab 10 mg/kg intravenously every 2 weeks. The primary objectives were safety and tolerability. Secondary objectives included confirmed objective response rate (Response Evaluation Criteria in Solid Tumors [RECIST] version 1.1), progression-free survival, overall survival (OS), and PD-L1-associated clinical activity. PD-L1 positivity was defined as expression by immunohistochemistry on ≥ 5% of tumor …

The Aki Clinic For Fragile Patients, Jerry Yee, Ruth C. Campbell

Nephrology Articles

No abstract provided.

Management Of Septic Shock, Rebecca E. Berger, Emanuel Rivers, Mitchell M. Levy

Emergency Medicine Articles

No abstract provided.